Host Commissioner Guidelines: People diagnosed with a Learning Disability and / or Autistic People

NHS England (NHSE) and NHS Improvement (NHSI) published Host Commissioner Guidance in January 2021 (updated in June 2023.  This describes a clear expectation that as the local Integrated Care Board (ICB) we ensure that we have assurances and maintain effective quality surveillance of independent hospitals caring for people who have been placed by different ICBs into Somerset.  For NHS Somerset this oversight relates to Cygnet Hospital Taunton which supports people with a diagnosis of a mental health condition or a diagnosis of a learning disability and / or autistic people. The hospital address is provided at the end of this page.

Whilst the Host Commissioner Guidance relates specifically to the quality of care for people with a diagnosis of Learning Disability and / or Autistic people, at NHS Somerset we have decided to extend elements of the oversight described by NHS England to all people placed at this location.

You can review the Host Commissioner guidelines for people diagnosed with a Learning Disability and / or Autistic people here.

You can also contact us via our Host Commissioner inbox at somicb.enquiries@nhs.net. Please mark it for the attention of the MH/LD Commissioning and Quality Teams.

At NHS Somerset our role as Host Commissioner is to:

• Maintain quality surveillance of our local independent hospital.
• Be the point of contact for all placing ICBs in relation to quality assurance queries.
• Collate intelligence and triangulate information to address any quality or safety issues.
• Share and request intelligence across commissioners placing people in our area.

The role of ICBs placing in Somerset is to:

• Inform host commissioners before you decide to place a person into our area.
• Talk to us about any quality or governance concerns you identify which are not addressed or managed appropriately and in a timely way by the hospital.
• Work with us by attending regular collaborative assurance meetings. The purpose of these is to share information across all system stakeholders and work together to support independent hospitals to maintain a high and consistent quality of service delivery, mitigate risk, resolve concerns, and highlight good practice.

 

Quality Assurance in Somerset

NHS Somerset's quality oversight for independent hospitals in our area includes:

• Ongoing and supportive contact to seek assurance about the quality of care delivered.
• Scheduled quality visits at least twice a year and regular meetings with the Hospital Manager.
• Collating intelligence provided by various stakeholders, such as placing commissioners, CQC, Safeguarding colleagues and Cygnet.
• Establishing a formal and collaborative assurance process across placing ICBs and other stakeholders where concerns have been identified or to enable the sharing of good practice and learning.

Please talk to us when you are considering placing a person with a diagnosis of a Learning Disability and / or Autistic people in Somerset.

 

NHSE Out of Area Placement Toolkit

If you intend to place a person in Somerset, we invite you to contact us in advance at: somicb.enquiries@nhs.net and we will be able to advise you of any current safety or quality concerns.  Please do not include person identifiable information in your emails, and as Host ICB we will never ask for identifiable information about people you place in our area.  Please mark your email for the attention of the MH/LD Commissioning and Quality Teams.

Working together with the LGA, South West ADASS, NHSE, health and social care commissioners, and co-produced with parent carers and people with lived experience, we have developed a set of tools to support improvements to the out of area placement process for when people move around the South West.

The tools are for commissioners, frontline practitioners, community support providers, parent carers and people with lived experience of a learning disability and are intended to offer best practice guidance when supporting someone who has been placed by a commissioner that is not from the host authority area.

The toolkit covers placements made in Registered Care (Residential) Homes, Supported Housing (Supported Independent Living), Community Support/ Domiciliary Care, and Residential Colleges.

-  Moving away from home commissioner                           -  OoA Commissioner Guidance (overview)

-  OoA Checklist for Providers                                               -  OoA Provider Guidance (overview)

-  OoA LA ICB Checklist                                                         -  OoA Families Checklist

Out of area placements do require an enhanced level of planning and co-ordination because the individual is being placed away, sometimes a considerable distance from their family and / or carers, the local authority or ICB with the statutory responsibility and knowledge of the individual being placed.

There is a duty of care to ensure a wider range of factors are considered and acted upon to support the safe transfer to a new placement, and importantly, ensure ongoing oversight and quality assurance by the placing authority.

It is important that both the host and placing authorities are mindful of the duties of each other and the need to co-operate in certain circumstances for the benefit of those with care and support needs.

Once you have placed a person in Somerset:

If you have already placed a patient within Somerset, please contact us so we can invite you to our Host Commissioner meetings; the meetings are held every six weeks and enable us to triangulate information.  We encourage all placing commissioners to discuss themes of concern (please note – individual issues should be raised by you with the hospital manager immediately) as well as to share positive experiences of Cygnet Hospital.

It is important that ICBs placing in Somerset talk to us about any quality or governance concerns they may identify.  This will help us triangulate information and address any identified concerns as Host Commissioner.  We also encourage our independent providers to talk to us about concerns that arise.  You can tell us about a concern by contacting us at somicb.enquiries@nhs.net. Please mark it for the attention of the MH/LD Commissioning and Quality Teams.

Reporting Safeguarding Concerns

We work very closely with our Local Authority Safeguarding Team to share intelligence about any allegations of abuse or neglect. Should you have any safeguarding concerns or wish to make a safeguarding referral it will be your responsibility as placing ICB to contact the Somerset Council Safeguarding Team. The Somerset Safeguarding Team will also contact you direct should a local safeguarding concern be raised that involves the person you have placed in Somerset.

For any safeguarding concerns about an independent hospital in Somerset please contact Somerset Adult Social Care Safeguarding Adults Team:

• Telephone: Somerset Direct 0300 123 2224
• Email: adults@somerset.gov.uk

To report an adult safeguarding concern in Somerset you can access the ‘Professionals Safeguarding Referral’ form on the Somerset Safeguarding Adults website (Somerset Safeguarding Adults.org.uk - see Key Links at the bottom of the home page)